Declining Childhood Immunisation Rates Australia | Whooping Cough Low

The Alarming Surge in Whooping Cough Cases Across Australia

Australia is facing its most significant whooping cough outbreak in over three decades, with 82,513 cases reported between 2024 and 2025—the highest since national monitoring began in 1991.41 In 2024 alone, 57,257 cases were detected, predominantly affecting school-aged and preschool children, marking the peak year on record.61 While cases dipped to around 1,300 in early 2026, experts warn that declining vaccination trends could fuel future epidemics.0 Whooping cough, or pertussis, caused by the bacterium Bordetella pertussis, starts like a common cold but escalates into severe, prolonged coughing fits that can lead to pneumonia, seizures, or even death in infants under six months, where the mortality rate hovers around one in 125.61

Australian universities, particularly the University of Sydney through its affiliation with the National Centre for Immunisation Research and Surveillance (NCIRS), have been at the forefront of tracking this crisis. Researchers like Dr. Archana Koirala, a paediatric infectious diseases specialist at the University of Sydney, highlight how COVID-19 disruptions interrupted routine cycles of exposure and immunity boosting, leaving populations more vulnerable.59

Childhood Immunisation Rates Reach a 10-Year Low

The latest data from NCIRS's Annual Immunisation Coverage Report 2024 reveals fully vaccinated coverage for children has plummeted to decade lows: 91.6% for 15-month-olds in 2024-25, down from a peak of 95% in 2020.62 For one-year-olds, it's 91.54%; two-year-olds, 89.57%; and five-year-olds, 93.17%—all below the 95% herd immunity threshold for diseases like pertussis.58 On-time vaccination has suffered too, with one in three children receiving their first MMR dose late and DTP coverage dropping 6.3 percentage points since early 2020.62

These declines are stark post-COVID, with Aboriginal and Torres Strait Islander children experiencing even steeper drops—coverage at 24 months below 90%.62 University-led analyses, such as those from the Grattan Institute in collaboration with public health academics, show four-in-five Tasmanian communities have seen protection levels fall since 2020, widening regional gaps.63

Post-COVID Disruptions: Root Causes of the Decline

The COVID-19 pandemic disrupted clinic visits, school-based vaccinations, and public trust, leading to persistent hesitancy. A 2025 national survey by NCIRS and Murdoch Children's Research Institute (MCRI) identified 15 key barriers, including access issues and acceptance concerns, with parental confidence in routine vaccines dropping from 93.8% pre-pandemic to 86.3%.69 Vaccine fatigue from COVID shots spilled over, compounded by misinformation and complacency as diseases like pertussis faded from memory.

• Clinic closures and lockdowns delayed routine shots.
• Reduced natural exposure prevented 'silent' immunity boosts.
• Hesitancy rose, with falsified records reports increasing.
• Socioeconomic and remote access barriers widened inequities.

Researchers at MCRI emphasize empathetic conversations to rebuild trust, while UNSW's Kirby Institute serosurveillance shows waning pertussis antibodies in over-60s, underscoring adult booster needs.95

University Research Illuminates Waning Immunity Challenges

Acellular pertussis vaccines provide strong initial protection but wane after 2-3 years, fueling cyclical epidemics every few years. University of Sydney and NCIRS studies confirm this, noting COVID restrictions broke the cycle, amassing susceptible individuals.61 UNSW Kirby Institute's serosurveillance reveals pertussis toxin antibodies undetectable in 49% of children after five years, predicting 69% by adolescence.29

Doherty Institute and Curtin University research on maternal pertussis vaccination shows 70% effectiveness in infants under two months, declining to 43% later, highlighting timing's importance.21 These findings drive calls for improved vaccines and surveillance.

Expert Voices from Australian Higher Education

Dr. Archana Koirala (University of Sydney) warns of pertussis's deadliness for babies and stresses adult boosters every decade.75 MCRI's vaccine uptake team, led by experts like Dr. Jess Kaufman, advocates supportive dialogues reducing distress from 60% to 32%.68 Grattan Institute analysts, drawing on uni data, urge targeted investments amid whooping cough at 35-year highs.63

UNSW Kirby's work on vaccine escape strains informs policy, while public health faculties across Australia collaborate on hesitancy studies.

Regional Disparities Amplify Risks

Coverage varies starkly: some areas like Gascoyne, WA (76.9%) or Nerang, QLD (82.2%) barely hit 80%, down sharply since 2020.60 Urban spots like Bankstown, Sydney (84.8%) and Keilor, Melbourne (88.8%) also lag. Universities like Western Sydney and Monash analyze these gaps, linking them to socioeconomic factors and access.60

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Public Health Impacts and Vulnerable Populations

Beyond infants, pertussis hospitalizes older children and causes complications like pneumonia in adults. Low rates threaten herd immunity, risking measles resurgence. Aboriginal children face steeper declines, per NCIRS data.62 Universities train epidemiologists vital for outbreak response.

Innovative University-Led Solutions

Australian academics propose:

• Boosters every 10 years for adults.
• Pregnancy vaccinations for infant protection.
• Targeted outreach in low-coverage areas.
• AI/data analytics for real-time tracking (UNSW-inspired).
• Hesitancy interventions via empathetic education (MCRI).

The National Immunisation Strategy 2025-2030, informed by uni research, emphasizes trust-building and equity.NCIRS Report

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The Pivotal Role of Higher Education in Vaccination Research

Institutions like University of Sydney (NCIRS), UNSW (Kirby), and MCRI lead serosurveillance, hesitancy studies, and vaccine trials. Their work informs policy, from maternal boosters to genomic tracking of strains. Aspiring researchers can find opportunities in higher ed jobs.

Photo by Annie Spratt on Unsplash

Future Outlook: Rebuilding Immunity Through Collaboration

With concerted efforts—university research, government funding, community engagement—Australia can reverse trends. Experts predict stabilization if boosters rise and hesitancy addressed. For career advice in public health academia, visit higher ed career advice. Explore Rate My Professor, higher ed jobs, university jobs, and Australian opportunities.